Phimosis

What is a tight foreskin?

The foreskin is the thin layer of skin that covers the tip of the penis. When someone has a tight foreskin (called phimosis), this skin cannot be pulled back easily or at all.

This is completely normal in babies and young boys. Most boys cannot pull back their foreskin until they are at least 5 years old, and sometimes not until they are 10 or older. This happens naturally as they grow up.

What are the signs?

If you or your child has a tight foreskin, you might notice:

• The foreskin cannot be pulled back from the tip of the penis
• The tip of the penis might bulge or balloon when peeing (this is normal in young boys)

Most of the time, a tight foreskin doesn't cause any problems. However, speak to your GP if you notice:

• Swelling and soreness
• Pain when peeing or a weak flow of pee
• Blood in urine
• Getting urine infections often
• Bleeding or thick discharge from under the foreskin
• An unpleasant smell (this could mean an infection)
• Painful erections

What can you do to help?

If the tight foreskin isn't causing problems like pain or bleeding, you can:

Do:

• Wash the penis regularly with warm water
• Use warm water and non-perfumed soap if needed
• Adults can gently pull back the foreskin as far as comfortable to clean underneath

Don't:

• Never force back a baby or young boy's foreskin - this can hurt them and cause problems later
• Don't use perfumed soaps, talcum powder or deodorants on the penis as these can cause irritation

When should you see your GP?

Speak to your GP if:

• The foreskin is tight and swollen or painful
• There's bleeding around the foreskin
• There's pain when peeing, thick discharge, or an unpleasant smell

What treatments are available?

For babies and young boys, the foreskin usually loosens naturally as they get older, so treatment often isn't needed.

If the tight foreskin is causing problems, your GP might suggest:

• Steroid creams or gels to help soften the foreskin
• Antibiotics if there's an infection
• Surgery to remove the foreskin (circumcision) or a small procedure to make cuts in the foreskin tip

Emergency warning signs

Call 999 or go to A&E immediately if the foreskin gets pulled back and cannot go back to cover the tip of the penis. This is called paraphimosis and is a medical emergency. The tip of the penis can become very swollen and painful.

Don't drive yourself to A&E - ask someone to drive you or call 999 for an ambulance.

Remember

A tight foreskin is very common and normal in babies and young boys. Most boys don't need any treatment as it gets better naturally as they grow. However, if you're worried about any symptoms, don't hesitate to speak to your GP for advice.

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Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.